KIMBERLY FISHBACH
NPI 1174126700
Psychologist in New York, NY

Active since November 17, 2020Opted out of Medicare · through Nov 20, 2026
177 PRINCE ST FL 4, NEW YORK, NY 10012(646) 537-1713 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimberly Fishbach NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY FISHBACH (NPI 1174126700) is an individual psychologist in New York, New York, licensed in New York (024010) and active in the NPI registry since November 2020. She has opted out of Medicare through November 20, 2026.

NPPES Registry Identity

NPI1174126700
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKIMBERLY FISHBACH
Location Address177 PRINCE ST FL 4New York, NY 10012-2946
Mailing Address177 Prince St Fl 4New York, NY 10012-2946
Sole ProprietorYes
Enumeration DateNovember 17, 2020
NPPES CertifiedNovember 17, 2020
NPI 1174126700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NY · 024010
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
177 PRINCE ST FL 4, New York, NY 10012

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Kimberly Fishbach has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 20, 2020 through November 20, 2026.

Opt-Out Effective DateNovember 20, 2020
Opt-Out In Effect ThroughNovember 20, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
177 PRINCE ST FL 4
NEW YORK, NY 10012
Psychologist (Clinical)
177 PRINCE ST FL 4
NEW YORK, NY 10012
Psychologist (Clinical)
177 PRINCE ST FL 4
NEW YORK, NY 10012

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Fishbach's NPI number?

The NPI number for Kimberly Fishbach is 1174126700. It was assigned to this individual provider in the NPPES registry on November 17, 2020.

Where is Kimberly Fishbach located?

Kimberly Fishbach practices at 177 Prince St Fl 4, New York, NY 10012. The listed phone number is (646) 537-1713.

What is Kimberly Fishbach's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kimberly Fishbach enrolled in Medicare?

No. Kimberly Fishbach has opted out of Medicare through November 20, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kimberly Fishbach was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.